@layout("/common/_container.html"){
<style>.projectBox > div{display:flex;margin:15px 0;}.projectBox > div > div{flex:1;display:flex;}.projectBox > div > div span{flex:1.15;}.projectBox > div > div div{flex:2}</style>
<div class="ibox float-e-margins">
    <div class="ibox-content">
        <div class="form-horizontal" id="reservationsInfoForm">
            <div style="display: none">
                <input type="hidden" id="id" value="">
                <input type="hidden" id="oneChannelValue" value="">
                <input type="hidden" id="twoChannelValue" value="">
                <input type="hidden" id="thrChannelValue" value="">
                <input type="hidden" id="oneMediumValue" value="">
                <input type="hidden" id="twoMediumValue" value="">
                <input type="hidden" id="thrMediumValue" value="">
                <input type="hidden" id="userNameValue" value="${userName}">
            </div>
            <div class="row">
                <h4 class="title_h">基本信息</h4>
                <div class="informationBox">
                    <div class="information_left">
                        <div>
                            <span>姓名<span class="asterisk">*</span></span>
                            <div><input autocomplete="off" id="customerName" type="text" class="input_style"></div>
                        </div>
                        <div>
                            <span>电话<span class="asterisk">*</span></span>
                            <div>
                                <input autocomplete="off" id="customerPhone" type="text" class="input_style" style="width: 45%" oninput="value=value.replace(/[^\d]/g,'')" maxlength="11">
                                @if(shiro.hasPermission("/reservations/reservationsPhones")){
                                <select name="phoneSharShip" id="phoneSharShip" style="width: 23%;" class="input_style">
                                    @for(str in refereeShipList){
                                    <option value="${str.refereeShip}">${str.refereeShip}</option>
                                    @}
                                </select>
                                <button type="button" class="btn" id="customerPhoneAdd">+</button>
                                @}
                            </div>
                        </div>
                        <div style="display: none" class="dianhua">
                            <span>电话2<span class="asterisk">*</span></span>
                            <div>
                                <input autocomplete="off" id="customerPhone2" type="text" class="input_style" oninput="value=value.replace(/[^\d]/g,'')" maxlength="11">
                            </div>
                        </div>
                        <div>
                            <span>状态<span class="asterisk">*</span></span>
                            <div>
                                <select id="statuss" name="statuss" class="input_style">
                                    <option value="">--请选择--</option>
                                    <option value="待定">待定</option>
                                    <option value="跟进">跟进</option>
                                    <option value="预约">预约</option>
                                    <option value="过期">过期</option>
                                </select>
                            </div>
                        </div>
                    </div>
                    <div class="information_right">
                        <div>
                            <span>性别</span>
                            <div style="height: 26px;line-height: 26px;">
                                <label style="margin: 0 0 0 10px;cursor: pointer"><input type="radio" name="sex" value="1" style="margin-right: 5px;">男</label>
                                <label style="margin: 0 0 0 10px;cursor: pointer"><input type="radio" name="sex" value="2" style="margin-right: 5px;">女</label>
                                <label style="margin: 0 0 0 10px;cursor: pointer"><input type="radio" name="sex" value="0" style="margin-right: 5px;" checked="checked">未知</label>
                            </div>
                        </div>
                        <div>
                            <span>年龄</span>
                            <div>
                                <input autocomplete="off" id="customerAge" type="text" class="input_style" oninput="value=value.replace(/[^\d]/g,'')" maxlength="2">
                            </div>
                        </div>
                    </div>
                </div>
            </div>
            <div class="row">
                <h4 class="title_h">项目信息</h4>
                <div class="projectBox" style="padding: 7px 20px;">
                    <div>
                        <div>
                            <span>预约项目<span class="asterisk">*</span></span>
                            <div>
                                <select id="appointmentPayService" name="appointmentPayService" class="select_style">
                                    <option value="">--请选择预约项目--</option>
                                    @for(str in departmentList){
                                    <option value="${str.department}">${str.department}</option>
                                    @}
                                </select>
                            </div>
                        </div>
                        <div>
                            <span>预约时间<span class="asterisk">*</span></span>
                            <div>
                                <input autocomplete="off" name="appointmentArrivalTime" id="appointmentArrivalTime" class="select_style" onclick="laydate({istime: true, format: 'YYYY-MM-DD hh:mm:ss',choose:checkDate})"/>
                            </div>
                        </div>
                        <div>
                            <span>地址</span>
                            <div><input autocomplete="off" id="address" name="address" class="select_style"></div>
                        </div>
                    </div>
                    <div>
                        <div>
                            <span>访问病种<span class="asterisk asterisks">*</span></span>
                            <div>
                                <select id="accessDisease" name="accessDisease" class="select_style">
                                    <option value="">--请选择--</option>
                                    <option value="种植">种植</option>
                                    <option value="正畸">正畸</option>
                                    <option value="修复">修复</option>
                                    <option value="美白">美白</option>
                                    <option value="牙周">牙周</option>
                                    <option value="医院类">医院类</option>
                                    <option value="拔牙智齿">拔牙智齿</option>
                                    <option value="洗牙洁牙">洗牙洁牙</option>
                                    <option value="儿童齿科">儿童齿科</option>
                                </select>
                            </div>
                        </div>
                        <div>
                            <span>预约门诊<span class="asterisk">*</span></span>
                            <div>
                                <select id="outpatientName" name="outpatientName" class="select_style">
                                    <option value="">--请选择门店--</option>
                                    @for(str in outpatientManagementList){
                                    <option value="${str.simplename}">${str.simplename}</option>
                                    @}
                                </select>
                            </div>
                        </div>
                        <div>
                            <span>建档人</span>
                            <div><input id="archiving" autocomplete="off" name="建档人" value="${userName}" class="select_style" readonly="readonly"/></div>
                        </div>
                    </div>
                    <div>
                        <div>
                            <span>一级渠道<span class="asterisk">*</span></span>
                            <div><select id="oneChannel" name="oneChannel" class="select_style">
                            </select></div>
                        </div>
                        <div>
                            <span>QQ</span>
                            <div>
                                <input id="qqNumber" autocomplete="off" type="text" class="select_style" oninput="value=value.replace(/[^\d]/g,'')">
                            </div>
                        </div>
                        <div>
                            <span>关键词</span>
                            <div>
                                <input id="keyWord" autocomplete="off" type="text" class="select_style">
                            </div>
                        </div>
                    </div>
                    <div>
                        <div>
                            <span>二级渠道<span class="asterisk">*</span></span>
                            <div><select id="twoChannel" name="twoChannel" class="select_style">
                                </select></div>
                        </div>

                        <div>
                            <span>微信</span>
                            <div>
                                <input id="wechatNumber" autocomplete="off" type="text" class="select_style">
                            </div>
                        </div>
                        <div>
                            <span>其他联系方式</span>
                            <div>
                                <input id="otherContact" autocomplete="off" type="text" class="select_style" oninput="value=value.replace(/[^\d]/g,'')">
                            </div>
                        </div>
                    </div>
                    <div>
                        <div>
                            <span>三级渠道<span class="asterisk">*</span></span>
                            <div><select id="thrChannel" name="thrChannel" class="select_style">
                            </select></div>
                        </div>

                        <div>
                            <span>障碍点</span>
                            <div><input id="obstaclePoint" autocomplete="off" class="select_style"/></div>
                        </div>
                        <div></div>
                    </div>
                    <div>
                        <div>
                            <span>预约医生</span>
                            <div><input id="doctor" name="doctor" class="select_style"/></div>
                        </div>

                        <div>
                            <span>预约TC</span>
                            <div><input id="tcName" name="tcName" class="select_style"/></div>
                        </div>
                        <div></div>
                    </div>
                </div>
            </div>
            <div class="row">
                <h4 class="title_h">其他信息</h4>
                <div style="display: flex;padding: 5px 20px;">
                    <div style="flex: 1;">
                        <p style="margin-bottom: 5px;">客户详情<span class="asterisk">*</span></p>
                        <textarea id="remarks" name="remarks" rows="4" style="width: 95%"></textarea>
                    </div>
                    <div style="flex: 1;">
                        <p style="margin-bottom: 5px;">聊天记录</p>
                        <textarea id="content" name="content" rows="4" style="width: 95%"></textarea>
                    </div>
                </div>
            </div>
            <div style="margin-bottom: 10px;">
                <div class="btnBox">
                    <button type="button" class="btn" style="background: #FF7E00;color: white" onclick="ReservationsInfoDlg.addSubmit('1')">提交</button>
                    <button type="button" class="btn" style="background: white;border: 1px solid #999999;color: inherit" onclick="ReservationsInfoDlg.close()">取消</button>
                </div>
            </div>
            <div class="row">
                <h4 class="title_h">补充信息</h4>
                <div class="informationBox">
                    <div class="information_left">
                        <div>
                            <span>一级媒介</span>
                            <div><input readonly="readonly" id="oneMedium" name="oneMedium" class="input_style"></div>
                        </div>
                        <div>
                            <span>二级媒介</span>
                            <div><input readonly="readonly" id="twoMedium" name="twoMedium" class="input_style"></div>
                        </div>
                        <div>
                            <span>三级媒介</span>
                            <div><input readonly="readonly" id="thrMedium" name="thrMedium" class="input_style"></div>
                        </div>
                        <div>
                            <span>职业</span>
                            <div><select id="occupation" class="input_style">
                                <option value="">--请选择职业--</option>
                                @for(str in occupationList){
                                <option value="${str.occupation}">${str.occupation}</option>
                                @}
                            </select></div>
                        </div>
                        <div>
                            <span>消费习惯</span>
                            <div><select id="consumptionHabits" name="consumptionHabits" class="input_style">
                                <option value="">--请选择消费习惯--</option>
                                @for(str in consumptionHabitsList){
                                <option value="${str.consumptionHabits}">${str.consumptionHabits}</option>
                                @}
                            </select>
                            </div>
                        </div>
                    </div>
                    <div class="information_right">
                        <div>
                            <span>经济能力</span>
                            <div>
                                <select id="economicAbility" class="input_style">
                                    <option value="">--请选择经济能力--</option>
                                    @for(str in economicAbilityList){
                                    <option value="${str.economicAbility}">${str.economicAbility}</option>
                                    @}
                                </select>
                            </div>
                        </div>
                        <div>
                            <span>是否大单</span>
                            <div>
                                <select id="isLarge" class="input_style">
                                    <option value="1">是</option>
                                    <option value="2">否</option>
                                </select>
                            </div>
                        </div>
                        <div>
                            <span>有无小孩</span>
                            <div><select id="isHaveChildren" name="isHaveChildren" class="input_style">
                                <option value="0">请选择</option>
                                <option value="1">有</option>
                                <option value="2">无</option>
                            </select></div>
                        </div>
                        <div>
                            <span>婚姻状况</span>
                            <div>
                                <select id="maritalStatus" name="maritalStatus" class="input_style">
                                    <option value="0">请选择</option>
                                    <option value="1">已婚</option>
                                    <option value="2">未婚</option>
                                    <option value="3">离异</option>
                                </select>
                            </div>
                        </div>
                        <div>
                            <span>性格</span>
                            <div><select id="characters" name="characters" class="input_style">
                                <option value="">--请选择性格--</option>
                                @for(str in charactersList){
                                <option value="${str.characters}">${str.characters}</option>
                                @}
                            </select></div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>
<script src="https://pynnn.oss-cn-hangzhou.aliyuncs.com/jsChannel.js?v=20200628"></script>
<script src="${ctxPath}/static/modular/marketing/reservations/reservations_addToNew.js?v=20200628"></script>
<script src="${ctxPath}/static/modular/marketing/reservations/reservations_addToNews.js?v=20200628"></script>
@}